29 results on '"R. Valtuille"'
Search Results
2. Nutrition, inflammation and oxidative stress - CKD 5D
- Author
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L. A. Usvyat, J. Raimann, S. Thijssen, F. M. van der Sande, J. Kooman, N. W. Levin, P. Kotanko, G. Von Gersdorff, M. Schaller, I. Bayh, M. Etter, A. Grassmann, A. Guinsburg, M. Lam, D. Marcelli, C. Marelli, L. Scatizzi, A. Tashman, T. Toffelmire, L. Usvyat, F. Van der Sande, Y. Wang, C. Barth, T. Moffitt, F. Hariton, M. Devlin, P. Garrett, M. Hannon-Fletcher, M. Ekramzadeh, Z. Sohrabi, M. Salehi, M. K. Fallahzadeh, M. Ayatollahi, B. Geramizadeh, J. Hassanzadeh, M. M. Sagheb, I. Beberashvili, I. Sinuani, A. Azar, H. Kadoshi, G. Shapiro, L. Feldman, Z. Averbukh, J. Weissgarten, Y. Abe, M. Watanabe, K. Ito, Y. Sasatomi, S. Ogahara, H. Nakashima, T. Saito, S. Witt, R. Kunze, H. J. Guth, H. Skarabis, J. Vienken, P. Nowak, R. Wilk, B. Mamelka, A. Prymont-Przyminska, A. Zwolinska, A. Sarniak, A. Wlodarczyk, J. Rysz, D. Nowak, L. Trajceska, P. Dzekova-Vidimliski, S. Gelev, S. Arsov, A. Sikole, M. Sonikian, A. Dona, I. Skarakis, P. Metaxaki, C. Chiotis, I. Papoutsis, A. Karaitianou, C. Spiliopoulou, F. M. Van der Sande, D. Teta, L. Tappy, N. Theumann, G. Halabi, T. Gauthier, C. Mathieu, S. Tremblay, P. Coti, M. Burnier, A. Zanchi, A. Martinez Vea, C. Cabre, D. Villa, M. Munoz, J. P. Vives, M. Arruche, J. Soler, M. T. Compte, J. Aguilera, M. Romeu, M. Giralt, G. Barril, S. Anaya, C. Vozmediano, A. Celayeta, R. Novillo, V. Bernal, I. Beiret, E. Huarte, J. Martin, H. Santana, G. Torres, F. Sousa, R. Sanchez, A. Lopez-Montes, F. Tornero, J. Uson, M. Pousa, M. Giorgi, B. Rdez Cubillo, R. Malhotra, S. R. Abbas, S. Thjissen, M. Carter, G. von Gersdorff, N. Levin, R. Jens, M. Tepel, E. Katharina, H. Andrea, F. Simone, S. Florian, O. Slusanschi, L. Garneata, R. Moraru, E. Preoteasa, C. Barbulescu, C. Santimbrean, C. Klein, D. Dragomir, G. Mircescu, T. Idorn, F. Knop, J. J. Holst, M. Hornum, B. Feldt-Rasmussen, Y. K. Son, W. S. An, S. E. Kim, K. H. Kim, S. Borrelli, R. Minutolo, L. De Nicola, G. Conte, W. De Simone, B. Zito, P. Guastaferro, F. Nigro, A. Bassi, L. Leone, O. Credendino, R. Genualdo, M. Capuano, G. Iulianiello, M. R. Auricchio, S. Sezer, Z. Bal, E. Tutal, M. Erkmen Uyar, F. N. Ozdemir Acar, S. Ribeiro, M. S. Faria, F. Melo, J. Sereno, I. Freitas, M. Mendonca, H. Nascimento, J. Fernandes, P. Rocha-Pereira, V. Miranda, D. Mendonca, A. Quintanilha, L. Belo, E. Costa, F. Reis, A. Santos-Silva, R. Valtuille, M. E. Casos, and E. A. Fernandez
- Subjects
Transplantation ,Nephrology ,business.industry ,Immunology ,medicine ,Inflammation ,medicine.symptom ,medicine.disease_cause ,business ,Oxidative stress - Published
- 2012
3. Worldwide Pharmacovigilance of a Biosimilar Product Containing Epoetin (Hemax®)
- Author
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E. Gonzalez, H. Ferro, R. Valtuille, and H. Donato
- Subjects
Pharmacology ,business.industry ,Pharmacology toxicology ,Pharmacovigilance ,Medicine ,Pharmacology (medical) ,Biosimilar ,Product (category theory) ,Toxicology ,business - Published
- 2008
4. The effects of cinacalcet in older and younger patients on hemodialysis: The evaluation of cinacalcet HCL therapy to lower cardiovascular events (EVOLVE) trial
- Author
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P. Ryckelynck, Y. Woredekal, T. Gehr, Marian Klinger, J. Passauer, K. Liss, E. Del Valle, B. Linares, Ferdinando Avella, Stolear Jc, S. Tolkan, O. Hermida, V. Wizemann, Ricardo Correa-Rotter, J. Santos, Gert Mayer, Michael Anger, B. Pellegrino, B. Wikström, A. Ståhl, H. Al-Bander, Pedro Alejandro Gordan, Philip A. Kalra, E. Galindo-Ramos, Carmine Zoccali, G. Dolson, M. Eigner, Sanjay Dalal, G. Touchard, J Peeters, G. Da Roza, Shannon Murphy, R. Errico, M. Lonergan, A. Andrusev, H. Boulechfar, P. Zaoui, Michael Suranyi, de Francisco Martín de Francisco, S. Jacobson, B. Gupta, C. Stafford, J. Picollo de Oliveira, Ilka Regina Souza de Oliveira, F. Dumler, J. Martinez Saye, E. de Almeida Romão, Emmanuel A. Burdmann, C. Vermeij, N. Kumar, E. Shahmir, J. Stratton, R. Schmidt, Mario Cozzolino, Lars Christian Rump, Rainer Oberbauer, J. Kumar, M. Saklayen, Brian Hutchison, C. Denu-Ciocca, L. Weiss, E. Friedman, L. Renders, K. Gurevich, L. Brandi, W. Shapiro, Kym M. Bannister, K. Berta, Muhammad M. Yaqoob, C. Lok, A. Pedrosa, Rosa M.A. Moysés, K. Bhandari, J. Arrieta, T. Crouch, Brigitte Maes, G. Wong, Myriam González, Matthew R. P. Davies, R. Gonzalez, Geoffrey A. Block, T. Nammour, T. Youell, J. Ramirez, S. Tobe, N. Ramirez, T. Bochicchio-Ricardelli, J. Cangiano-Rivera, D. Streja, J. Endsley, K. Ang, R. Patak, J. Cheng, T. Rogers, Alberto Albertazzi, H. Holzer, G. Choukroun, Jose A.L. Arruda, Philippe Rieu, P. Simon, Stephen Z. Fadem, Jared G. Sugihara, H. Alfred, Bruce F. Culleton, G. Frascà, Giovanni Pertosa, W. Van Kuijk, H. Beresan, Samuel S. Blumenthal, Piergiorgio Messa, H. Baer, Michael C. Braun, B. Rutkowski, W. Riegel, M. Komandenko, V. Ermolenko, Martin Wilkie, N. Muirhead, Peter G. Kerr, D. Rattensberger, J. Sabto, Anjay Rastogi, L. Lef, M. El Shahawy, D. Tharpe, A. Smirnov, J. Pons, F. García, F. Zantvoort, A. Lionet, J. Topf, Marcia R. Silver, Reinhard Kramar, E. Moriero, A. Rekhi, S. Roe, P. Batista, E. Kolmakova, F. Rahim, M. Ostrowski, Janice P. Lea, Patrizia Ondei, C. Martinez, J. Donck, Nicole Lopez, F. Schena, Allen R. Nissenson, Alex P.S. Disney, R. Valtuille, C. Najun Zarazaga, M. Fraenkel, Pieter Evenepoel, R. Cottiero, S. Di Giulio, V. Gura, S. Karunakaran, P. Nader, F. Saldanha Thome, Walter Douthat, A. Fekete, L. Arbeit, W. Sulowicz, I. Marin, Charles R.V. Tomson, Andrzej Wiecek, Luis A. Juncos, G. Mingardi, P. Light, Max Dratwa, H. Reichel, R. Raja, U. Ranjit, G. Sterner, E. Coll Piera, P. Pai, Robert J. Walker, R. Bregman, E. Hübel, M. Timofeev, T. Szabo, A. Elli, N. Padmanabhan, N. Garrote, M. Mysliwiec, David C. Wheeler, J. Cruz-Valdez, R. Klauser, Maree-Ross Smith, Antonio Carlos Carvalho, A. Losito, M. Durlik, G. Petraglia, Gianni Cappelli, Y. Lien, M. Chaffin, N. García, R. Halligan, Glenn M. Chertow, M. Bastos, P. Smak Gregoor, S. Ong, M. Belledonne, Fredric O. Finkelstein, J. Martínez García, R. Pecoits Filho, M. Klingberg, B. Carvalho, S. Noble, T. Plumb, A. Chew Wong, Michael Roppolo, U. Neyer, S. Ahmad, J. Mackie, R. Minasian, M. Verrelli, A. Abukurah, M. Laski, P. Brunet, Madeleine V. Pahl, Daniel Zehnder, E. Alas, Muralidhar Acharya, G. Rudolf, G. Zakar, M. Reddy, R. Specter, G. Grandaliano, I. Kulcsar, A. Amatya, Eugenie Pedagogos, O. Ayodeji, G. Jensen, S. Diamond, Xavier Warling, P. Teredesai, M. Mathew, M. Haque, M. Solis, E. Andrés Ribes, M.A. van den Dorpel, Akhtar Ashfaq, Christian Rabbat, David G. Warnock, M. Sebastian Diaz, C. Mousson, R. Darwish, M. Sperto Baptista, N. Salgado, E. Alvarez Sandoval, M. Vasilevsky, P. Chidester, D. Polack, Simon J. Davies, G. Brosnahan, A. Agarwal, Chaim Charytan, T. Hannedouche, M. Gross, I. Arias, G. James, Jürgen Floege, Tom Dejagere, Patrick S. Parfrey, S. Cournoyer, T. Cavalieri, Gérard M. London, K. Gandhi, A. Kshirsagar, O. Khrustalev, J. Zacharias, Michel Dhaene, Jennifer Tuazon, W. Weise, J. Guzman-Rivera, HS Brink, Alastair J. Hutchison, P. D. Cunha, Robyn G Langham, S. Soman, J. Goldman, S. Kazup Erdelyine, A. Widerhorn, M. Henriquez, N. Hunt, W. Hoerl, O. Arkossy, J. Szegedi, R. Dhingra, M. Fernandez Lucas, Jesus Navarro, A. Kark, Andrey Gurevich, Cynthia J. Brown, Rajnish Mehrotra, L. Kleinman, S. Ferenczi, Loreto Gesualdo, V. Schwenger, M. Ramirez, N. Mittman, Ana María Cusumano, K. Marczewski, Moustafa Moustafa, Sônia M. H. A. Araújo, E. Ladanyi, M. Auricchio, Maurice Laville, P. Urena Torres, C. Gallart, A. Israelit, V. Altobelli, E. Hagen, S. Nosrati, John P. Middleton, Kant Ks, F. Al-Saghir, S. Steinberg, S. Neiva Coelho, Botond Csiky, Philip G Zager, M. Sekkarie, Vanda Jorgetti, Domingos O. d'Avila, Carol A. Pollock, L. Lai, B. von Albertini, Beckie Michael, U. Kunzendorf, N. Frischmuth, A. Durrbach, L. Vasconcellos, Raymond Vanholder, M. Dickenmann, B. Schiller-Moran, Steven D. Soroka, J. Rubin, O. Balkarova, S. Morse, M. Teixeira Araújo, D. Perlin, M. Khan, C. Hura, Dagmar-C. Fischer, D. Machado, Seamas C. Donnelly, D. Sapir, V. Lorica, L. Deboni, M. Jose, M. Galicia, K. Bidas, David Spiegel, David Goldsmith, Peter F Mount, A. Strokov, L. Yu, J. Pitone, Biagio Ricciardi, Alastair Gillies, M. Moyses Neto, Piergiorgio Bolasco, V. Anashkin, John R. Sedor, M. Lee, E.M. Jones, M. Culpepper, G. London, D. Joly, N. Khadikova, Charles A. Herzog, P. Meier, M. Farina, Dana V. Rizk, William M. McClellan, M. Cook, Bastian Dehmel, Patrizia Ferrari, F. Almeida, V. Pogue, R. McCrary, F. Macario, J. Golden, E. Wijeyesinghe, Tilman B. Drüeke, E. Osanloo, M. Muszytowski, F. Arif, Giuseppe Villa, M. Torres Zamora, Steven Zeig, N. Thompson, A. Jamal, C. Sholer, P. Stroumza, D. Reddan, Arun Gupta, J. Montenegro, T. DelGiorno, D. Eadington, G. Shostka, Michel Jadoul, A. Weigert, Sergio Stefoni, P. Dreyer, Carmel M. Hawley, J. Cardeal da Costa, M. Switalski, G. Talaulikar, A. Felsenfeld, J. MacLaurin, T. Herman, N. Pritchard, M. Michaud, K.-U. Eckardt, R. Romero, G. Volgina, Fred E. Husserl, J. Soler Amigó, David S. Goldfarb, A. Matalon, M. D. Torres, P. Sampaio Lacativa, L. Major, U. Lund, A. Lafalla, S. Sarkar, Jennifer M. MacRae, J. Lobo, Liudmila Rozhinskaya, Johann Braun, H. Daugaard, S. Khokhar, S. Rubinstein, D. Bhatia, G. Timokhovskaya, T. Wooldridge, A. Voßkühler, Nelson Kopyt, Pablo E. Pergola, Michel Burnier, L. Samuels, J. Alcázar de La Ossa, J. Billiouw, R. Liebl, P. Sidhu, S. Menahem, P. Montambault, E. Schwertfeger, K. Staroselsky, J. Kovarik, S. Horn, N. Tareen, Simon D. Roger, Francesco Locatelli, Kenneth W. Mahaffey, J Vanwalleghem, Robert I. Lynn, M. Prados, K. Kapatkin, N. Peñalba, Kailash Jindal, M. Stegman, R. Stahl, Joseph A. Eustace, S. Desmeules, A. Hazzan, D. Scott, B. Taparia, G. Keightley, P. Jensen, V. Ortalda, K. McConnell, Alejandro Martin-Malo, Margaret M. Williams, Stuart M. Sprague, S. Chow, Diego Brancaccio, Yumi Kubo, P. Dykes, E. de Francesco Daher, C. Erley, Joanna Matuszkiewicz-Rowińska, T. Minga, I. Dasgupta, Galen S. Wagner, N. Marchetta, R. Rigolosi, P. Raguram, P. Lang, P. Cambier-Dwelschauwers, A. Tsang, M. Schonefeld, W. Bentkowski, Z. Sharon, Daniel Batlle, James T. McCarthy, M. Vital Flores, M. Rambausek, A. Zemtchenkov, Fabio Malberti, V. Thakur, O. Domashenko, D. Wheeler, J. Capelli, Bernard Jones, D. Uehlinger, K. Olgaard, K. Lhotta, M. Bernardo, S. Goldberger, Alison Thomas, E. Dunnigan, A. Ksiazek, A. Assefi, C. Poole, G. Rosa Diez, G. Newman, J. Cotton, C. Combe, B. Murthyr, Sharon M. Moe, H. Neumayer, J. Mittleman, Robert G. Fassett, W. Cleveland, F. van der Sande, C. Vela, H. Fessi, J. Robertson, Giuseppe Cannella, Bryan N. Becker, João M. Frazão, V. Shilo, M. Rano, J. De Meester, R. Fiedler, J. Floege, B. Murray, Giovambattista Capasso, F. Dellanna, J. Luiz Gross, K. Tucker, C. Santiago, Paul J. Martin, M. Nowicki, L. Friedman, William G. Goodman, G. Diez, Markus Ketteler, S. Arfeen, I. Mezei, J. Ortiz, Elizabeth E. Brown, Deborah Zimmerman, Aleix Cases, M. El Khatib, Martine Leblanc, R. Daelemans, K. Malireddi, C. Rikker, R. Gladish, F. Aranda Verástegui, R. Kopelman, B. Borbas, J. Buerkert, K. Ntoso, J. Peña, V. Garcia, C. West, M. Azer, J. Kwan, J. Sterrett, P. Swift, A. Raff, R. Kohli, S. Lew, Steven J. Rosansky, H. Graf, K. Bouman, F. Skinner, C. Tielemans, S. Ferreira Filho, Jocemir Ronaldo Lugon, M. Weinberg, Parfrey, P. S., Drueke, T. B., Block, G. A., Correa-Rotter, R., Floege, J., Herzog, C. A., London, G. M., Mahaffey, K. W., Moe, S. M., Wheeler, D. C., Kubo, Y., Dehmel, B., Goodman, W. G., Chertow, G. M., Santos, J., Najun Zarazaga, C., Marin, I., Garrote, N., Cusumano, A., Penalba, N., Del Valle, E., Juncos, L., Martinez Saye, J., Lef, L., Altobelli, V., Petraglia, G., Rosa Diez, G., Douthat, W., Lobo, J., Gallart, C., Lafalla, A., Diez, G., Linares, B., Lopez, N., Ramirez, N., Gonzalez, R., Valtuille, R., Beresan, H., Hermida, O., Rudolf, G., Marchetta, N., Rano, M., Ramirez, M., Garcia, N., Gillies, A., Jones, B., Pedagogos, E., Walker, R., Talaulikar, G., Bannister, K., Suranyi, M., Kark, A., Roger, S., Kerr, P., Disney, A., Mount, P., Fraenkel, M., Mathew, M., Fassett, R., Jose, M., Hawley, C., Lonergan, M., Mackie, J., Ferrari, P., Menahem, S., Sabto, J., Hutchison, B., Langham, R., Pollock, C., Holzer, H., Oberbauer, R., Arias, I., Graf, H., Mayer, G., Lhotta, K., Neyer, U., Klauser, R., Hoerl, W., Horn, S., Kovarik, J., Kramar, R., Eigner, M., Dhaene, M., Billiouw, J., De Meester, J., Warling, X., Cambier-Dwelschauwers, P., Evenepoel, P., Daelemans, R., Dratwa, M., Maes, B., Stolear, J., Dejagere, T., Vanwalleghem, J., Bouman, K., Jadoul, M., Peeters, J., Vanholder, R., Tielemans, C., Donck, J., Almeida, F., Picollo de Oliveira, J., Burdmann, E., Garcia, V., Saldanha Thome, F., Deboni, L., Bregman, R., Lugon, J., Araujo, S., Ferreira Filho, S., de Francesco Daher, E., Sperto Baptista, M., Carvalho, A., D'Avila, D., Moyses Neto, M., Yu, L., Bastos, M., Sampaio Lacativa, P., Jorgetti, V., de Almeida Romao, E., Cardeal da Costa, J., Pecoits Filho, R., Gordan, P., Salgado, N., Teixeira Araujo, M., Neiva Coelho, S., Oliveira, I., Moyses, R., Vasconcellos, L., Batista, P., Luiz Gross, J., Pedrosa, A., Cournoyer, S., Leblanc, M., Chow, S., Karunakaran, S., Wong, G., Tobe, S., Desmeules, S., Zimmerman, D., Murphy, S., Montambault, P., Donnelly, S., Macrae, J., Culleton, B., Soroka, S., Rabbat, C., Jindal, K., Vasilevsky, M., Michaud, M., Wijeyesinghe, E., Zacharias, J., Lok, C., Muirhead, N., Verrelli, M., Da Roza, G., Sapir, D., Olgaard, K., Daugaard, H., Brandi, L., Jensen, P., Boulechfar, H., Ang, K., Simon, P., Rieu, P., Brunet, P., Touchard, G., London, G., Urena Torres, P., Combe, C., Durrbach, A., Ortiz, J., Hannedouche, T., Vela, C., Lionet, A., Ryckelynck, P., Zaoui, P., Choukroun, G., Fessi, H., Lang, P., Stroumza, P., Joly, D., Mousson, C., Laville, M., Dellanna, F., Erley, C., Braun, J., Rambausek, M., Riegel, W., Klingberg, M., Schwertfeger, E., Wizemann, V., Eckardt, K., Reichel, H., Passauer, J., Hubel, E., Frischmuth, N., Liebl, R., Fiedler, R., Schwenger, V., Vosskuhler, A., Kunzendorf, U., Renders, L., Rattensberger, D., Rump, L., Ketteler, M., Neumayer, H., Zantvoort, F., Stahl, R., Ladanyi, E., Kulcsar, I., Mezei, I., Csiky, B., Rikker, C., Arkossy, O., Berta, K., Szegedi, J., Major, L., Ferenczi, S., Fekete, A., Szabo, T., Zakar, G., Wagner, G., Kazup Erdelyine, S., Borbas, B., Eustace, J., Reddan, D., Capasso, G., Locatelli, F., Villa, G., Cozzolino, M., Brancaccio, D., Messa, P., Bolasco, P., Ricciardi, B., Malberti, F., Moriero, E., Cannella, G., Ortalda, V., Stefoni, S., Frasca, G., Cappelli, G., Albertazzi, A., Zoccali, C., Farina, M., Elli, A., Avella, F., Ondei, P., Mingardi, G., Errico, R., Losito, A., Di Giulio, S., Pertosa, G., Schena, F., Grandaliano, G., Gesualdo, L., Auricchio, M., Bochicchio-Ricardelli, T., Aranda Verastegui, F., Pena, J., Chew Wong, A., Cruz-Valdez, J., Torres Zamora, M., Solis, M., Sebastian Diaz, M., Vital Flores, M., Alvarez Sandoval, E., van den Dorpel, M., Brink, H., Van Kuijk, W., Vermeij, C., Smak Gregoor, P., Hagen, E., van der Sande, F., Klinger, M., Nowicki, M., Muszytowski, M., Bidas, K., Bentkowski, W., Wiecek, A., Ksiazek, A., Marczewski, K., Ostrowski, M., Switalski, M., Sulowicz, W., Matuszkiewicz-Rowinska, J., Mysliwiec, M., Durlik, M., Rutkowski, B., Macario, F., Carvalho, B., Frazao, J., Machado, D., Weigert, A., Andrusev, A., Khrustalev, O., Zemtchenkov, A., Gurevich, K., Staroselsky, K., Khadikova, N., Rozhinskaya, L., Timokhovskaya, G., Strokov, A., Balkarova, O., Ermolenko, V., Kolmakova, E., Komandenko, M., Timofeev, M., Shilo, V., Shostka, G., Smirnov, A., Anashkin, V., Volgina, G., Domashenko, O., Gurevich, A., Perlin, D., Martinez Garcia, J., Andres Ribes, E., Coll Piera, E., Fernandez Lucas, M., Galicia, M., Prados, M., Gonzalez, M., Romero, R., Martin de Francisco, A., Montenegro, J., Santiago, C., Garcia, F., Alcazar de La Ossa, J., Arrieta, J., Pons, J., Martin-Malo, A., Soler Amigo, J., Cases, A., Sterner, G., Jensen, G., Wikstrom, B., Jacobson, S., Lund, U., Weiss, L., Stahl, A., von Albertini, B., Burnier, M., Meier, P., Martin, P., Uehlinger, D., Dickenmann, M., Yaqoob, M., Zehnder, D., Kalra, P., Padmanabhan, N., Roe, S., Eadington, D., Pritchard, N., Hutchison, A., Davies, S., Wilkie, M., Davies, M., Pai, P., Swift, P., Kwan, J., Goldsmith, D., Tomson, C., Stratton, J., Dasgupta, I., Sarkar, S., Moustafa, M., Gandhi, K., Jamal, A., Galindo-Ramos, E., Tuazon, J., Batlle, D., Tucker, K., Schiller-Moran, B., Assefi, A., Martinez, C., Samuels, L., Goldman, J., Cangiano-Rivera, J., Darwish, R., Lee, M., Topf, J., Kapatkin, K., Baer, H., Kopelman, R., Acharya, M., Tharpe, D., Bernardo, M., Nader, P., Guzman-Rivera, J., Pergola, P., Sekkarie, M., Alas, E., Zager, P., Liss, K., Navarro, J., Roppolo, M., Denu-Ciocca, C., Kshirsagar, A., El Khatib, M., Kant, K., Scott, D., Murthyr, B., Finkelstein, F., Keightley, G., Mccrary, R., Pitone, J., Cavalieri, T., Tsang, A., Pellegrino, B., Schmidt, R., Ahmad, S., Brown, C., Friedman, E., Mittman, N., Fadem, S., Shapiro, W., Reddy, M., Goldberger, S., Woredekal, Y., Agarwal, A., Anger, M., Haque, M., Chidester, P., Kohli, R., Rubinstein, S., Newman, G., Gladish, R., Ayodeji, O., Soman, S., Sprague, S., Hunt, N., Gehr, T., Rizk, D., Warnock, D., Polack, D., Pahl, M., Fischer, D., Dreyer, P., James, G., Husserl, F., Rogers, T., Raff, A., Sedor, J., Silver, M., Smith, M., Steinberg, S., Delgiorno, T., Jones, E., Cunha, P. D., Cheng, J., Pogue, V., Blumenthal, S., Brown, E., Charytan, C., Buerkert, J., Cook, M., Felsenfeld, A., Tareen, N., Gupta, A., Herman, T., Diamond, S., Hura, C., Laski, M., Maclaurin, J., Plumb, T., Brosnahan, G., Kumar, J., Henriquez, M., Poole, C., Osanloo, E., Matalon, A., Sholer, C., Arfeen, S., Azer, M., Belledonne, M., Gross, M., Dunnigan, E., Mcconnell, K., Becker, B., Skinner, F., Rigolosi, R., Spiegel, D., Stegman, M., Patak, R., Streja, D., Ranjit, U., Youell, T., Wooldridge, T., Stafford, C., Cottiero, R., Weinberg, M., Schonefeld, M., Shahmir, E., Hazzan, A., Ashfaq, A., Bhandari, K., Cleveland, W., Culpepper, M., Golden, J., Lai, L., Lien, Y., Lorica, V., Robertson, J., Malireddi, K., Morse, S., Thakur, V., Israelit, A., Raguram, P., Alfred, H., Weise, W., Al-Saghir, F., El Shahawy, M., Rastogi, A., Nissenson, A., Kopyt, N., Lynn, R., Lea, J., Mcclellan, W., Teredesai, P., Ong, S., Tolkan, S., Sugihara, J., Minga, T., Mehrotra, R., Minasian, R., Bhatia, D., Specter, R., Capelli, J., Sidhu, P., Dalal, S., Dykes, P., Khan, M., Rahim, F., Saklayen, M., Thomas, A., Michael, B., Torres, M., Al-Bander, H., Murray, B., Abukurah, A., Gupta, B., Nosrati, S., Raja, R., Zeig, S., Braun, M., Amatya, A., Endsley, J., Sharon, Z., Dolson, G., Dumler, F., Ntoso, K., Rosansky, S., Kumar, N., Gura, V., Thompson, N., Goldfarb, D., Halligan, R., Middleton, J., Widerhorn, A., Arbeit, L., Arruda, J., Crouch, T., Friedman, L., Khokhar, S., Mittleman, J., Light, P., Taparia, B., West, C., Cotton, J., Dhingra, R., Kleinman, L., Arif, F., Lew, S., Nammour, T., Sterrett, J., Williams, M., Ramirez, J., Rubin, J., Mccarthy, J., Noble, S., Chaffin, M., and Rekhi, A.
- Subjects
Parathyroidectomy ,Adult ,Male ,medicine.medical_specialty ,Cinacalcet ,Epidemiology ,medicine.medical_treatment ,Calcimimetic Agents ,Critical Care and Intensive Care Medicine ,Lower risk ,Severity of Illness Index ,CKD ,cardiovascular disease ,hemodialysis ,hyperparathyroidism ,mineral metabolism ,Age Factors ,Aged ,Aged, 80 and over ,Cardiovascular Diseases ,Cinacalcet Hydrochloride ,Female ,Humans ,Hyperparathyroidism, Secondary ,Kidney Failure, Chronic ,Kidney Transplantation ,Middle Aged ,Renal Dialysis ,Nephrology ,Transplantation ,Internal medicine ,medicine ,Intensive care medicine ,Hyperparathyroidism ,business.industry ,Original Articles ,medicine.disease ,Secondary hyperparathyroidism ,Hemodialysis ,business ,medicine.drug - Abstract
Background andobjectivesThecalcimimeticcinacalcet reduced therisk of death or cardiovascular (CV) events in older, but not younger, patients with moderate to severe secondary hyperparathyroidism (HPT) who were receiving hemodialysis. To determine whether the lower risk in younger patients might be due to lower baseline CV risk and more frequent use of cointerventions that reduce parathyroid hormone (kidney transplantation, parathyroidectomy, and commercial cinacalcet use), this study examined the effects of cinacalcet in older ($65 years, n=1005) and younger (,65 years, n=2878) patients. Design, setting, participants, & measurements Evaluation of Cinacalcet HCl Therapy to Lower Cardiovascular Events (EVOLVE) was a global, multicenter, randomized placebo-controlled trial in 3883 prevalent patients on hemodialysis, whose outcomes included death, major CV events, and development of severe unremitting HPT. The age subgroup analysis was prespecified. ResultsOlderpatients hadhigher baselineprevalenceof diabetesmellitusandCV comorbidity. Annualizedrates of kidney transplantation and parathyroidectomy were .3-fold higher in younger relative to older patients and were more frequent in patients randomized to placebo. In older patients, the adjusted relative hazard (95% confidence interval) for the primary composite (CV) end point (cinacalcet versus placebo) was 0.70 (0.60 to 0.81); in younger patients, the relative hazard was 0.97 (0.86 to 1.09). Corresponding adjusted relative hazards for mortality were 0.68 (0.51 to 0.81) and 0.99 (0.86 to 1.13). Reduction in the risk of severe unremitting HPT was similar in both groups. Conclusions In the EVOLVE trial, cinacalcet decreased the risk of death and of major CV events in older, but not younger, patients with moderate to severe HPT who were receiving hemodialysis. Effect modification by age may be partly explained by differences in underlying CV risk and differential application of cointerventions that reduce parathyroid hormone. Clin J Am Soc Nephrol 10: ccc–ccc, 2015. doi: 10.2215/CJN.07730814
- Published
- 2015
5. P6.20 VASCULAR ACCESSES FOR HAEMODIALYSIS IN THE ARM CAUSE GREATER REDUCTION IN THE CAROTID-BRACHIAL STIFFNESS THAN THOSE IN THE FOREARM: STUDY OF GENDER DIFFERENCES
- Author
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M.C. Saldías, Edmundo I. Cabrera-Fischer, Daniel Bia, R. Valtuille, I. Álvarez, Cintia Galli, Héctor Pérez, Sebastian Graf, Yanina Zócalo, and Ricardo L. Armentano
- Subjects
medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Stiffness ,Specialties of internal medicine ,General Medicine ,Surgery ,medicine.anatomical_structure ,Forearm ,RC581-951 ,Internal medicine ,RC666-701 ,Cardiology ,Medicine ,Diseases of the circulatory (Cardiovascular) system ,medicine.symptom ,business ,Reduction (orthopedic surgery) - Published
- 2011
6. Partial Least Squares Regression: A Valuable Method for Modeling Molecular Behavior in Hemodialysis.
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R. Valtuille and P. Willshaw
- Abstract
Abstract The aim of this work was to use the Partial Least Squares Regression (PLS) technique to fit simple models for the interpretation of an underlying complex process. In this study, the technique was used to build a statistical model for molecular kinetic data obtained from hemodialyzed patients. By using PLS we derived statistical linear models for the prediction of the equilibrated urea concentration which would be reached 30–60 min after the end of the dialysis session. Models with an average relative prediction error (RPE) of less than 0.05% were achieved. The model predictive accuracy was evaluated in a cross-center study yielding an RPE [ABSTRACT FROM AUTHOR]
- Published
- 2008
7. Four Year Experience in CAPD
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E. Chaya, A. Locatelli, E. Castiglioni, R. Valtuille, M. Fuentes, C. Marelli, L. DeBenedetti, N. Marchetta, A. Heilbron, and L. Lef
- Subjects
medicine.medical_specialty ,business.industry ,media_common.quotation_subject ,Motor nerve conduction velocity ,medicine.medical_treatment ,Continuous ambulatory peritoneal dialysis ,urologic and male genital diseases ,female genital diseases and pregnancy complications ,Independence ,Peritoneal dialysis ,Quality of life ,Internal medicine ,medicine ,Chronic pyelonephritis ,Hemodialysis ,business ,Serum chemistry ,media_common - Abstract
CAPD provides a viable alternative to hemodialysis for ESRD, because of the serum chemistry and clinic results obtained and the independence and quality of life that patients can achieve. Nineteen patients treated by CAPD for an average of 19.4 mo demonstrate the adequacy of this treatment.
- Published
- 1986
8. Cardiovascular Risk Related to Glomerular Hyperfiltration in Nondiabetic Individuals: Increasing Visibility is Crucial.
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Valtuille R
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- Middle Aged, Humans, Aged, Risk Factors, Heart Disease Risk Factors, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Sodium-Glucose Transporter 2 Inhibitors, Hypertension, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic epidemiology
- Abstract
Glomerular hyperfiltration (GHF), defined by different estimation formulas, has been widely studied as a predictor of proteinuria and progression to chronic kidney disease (CKD) in diabetic patients. GHF is also an important cardiovascular (CV) risk factor and is related to allcause mortality in non-diabetic populations; however, the upper limit of glomerular filtration rate (GFR) above which it indicates the presence of GHF is weakly defined. This higher risk is as high as in the intermediate stages of CKD and is greater than the presence of diabetes or smoking and is still present in non-albuminuria patients. The original Chronic Kidney Disease Epidemiology Collaboration (CKD-EPI) estimation GFR formula showed lower error at higher glomerular filtration (GF) values, was the most used in population studies, and behaved as a better risk predictor. In our review (including approximately 3.6 million individuals), higher GFR values related to increased mortality risk varied from 106.6 to 113.7 ml/min, which are usually not considered risk values for standard guidelines in non-albuminuric patients. However, the lack of consensus on a GF cutoff value, as well as its variability due to sex and progressive reduction with age, affect the knowledge of this serious phenomenon in clinical practice. Although the elderly population is not exempted from the effects of GHF, the search for this phenomenon should be intensified in middle-aged populations because of their lower disease burden, where this situation may be more evident, and the possibility of reversing the consequences is greater. A population group often considered healthy includes obese people, essential hypertensives, smokers, and carriers of fatty liver, where the GHF phenomenon is frequent and is associated with CV disease, kidney disease, and higher mortality. Increasing its visibility by the medical community is essential to reduce the effects of GHF, emphasizing more frequent controls and implementing general measures that include strict control of hypertension, Na restriction, rich in vegetables diets and increased physical activity. Initiatives to confirm the beneficial effects of sodium-glucose cotransporter-2 inhibitors to treat isolated GHF would be an important breakthrough in reducing the severe consequences of this phenomenon., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
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- 2023
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9. Potential Novel Benefits of Sodium Restriction in Chronic Kidney Disease.
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Valtuille R
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- Humans, Sodium, Sodium Chloride, Dietary adverse effects, Hypertension, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic epidemiology, Sodium, Dietary
- Abstract
Chronic kidney disease is a global public health issue, and it has been considered as the epidemic of the 21st century. Therefore, all initiatives addressed to slow down the evolution and complications of this condition should be well received. While the effects of salt reduction on cardiovascular disease have some controversial issues, in chronic kidney disease, such a policy is beneficial in multiple aspects. In chronic kidney disease patients, dietary sodium restriction is regularly recommended to control extracellular fluid expansion, hypertension and cardiovascular risk. Instead, the effects of sodium reduction on chronic kidney disease progression are still controversial. In the last years, potentially beneficial effects of a low sodium diet on chronic kidney disease evolution have emerged. Firstly, recent magnetic resonance-based findings of increased Na depots in skin and muscle associated with renal function, ageing and sodium intake open a vast body of investigation as a potential tool for monitoring effects of sodium restriction. In this narrative review, we also discussed novel aspects of sodium restriction in chronic kidney disease to manage metabolic acidosis as well as renal effects on fibroblast growth factor 23 or gut microbiota. Beyond current evidence, these approaches showed that common findings of kidney failure environment such as sodium -sensitivity, micro-inflammation, arterial stiffness metabolic acidosis and sarcopenia could be delayed controlling dietary sodium. Additional studies are now needed in populations with chronic kidney disease to confirm these new findings, addressed to slow down the evolution and complications of this condition., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)
- Published
- 2021
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10. Central-To-Peripheral Arterial Stiffness Gradient in Hemodialyzed Patients Depends on the Location of the Upper-limb Vascular Access.
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Bia D, Galli C, Zocalo Y, Valtuille R, Wray S, Pessana F, and Cabrera-Fischer EI
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- Adult, Aged, Aged, 80 and over, Cardiovascular Diseases etiology, Cardiovascular Diseases physiopathology, Case-Control Studies, Cross-Sectional Studies, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Renal Insufficiency, Chronic complications, Renal Insufficiency, Chronic diagnosis, Renal Insufficiency, Chronic physiopathology, Reproducibility of Results, Risk Factors, Treatment Outcome, Arteriovenous Shunt, Surgical adverse effects, Cardiovascular Diseases diagnosis, Pulse Wave Analysis, Renal Dialysis adverse effects, Renal Insufficiency, Chronic therapy, Upper Extremity blood supply, Vascular Stiffness
- Abstract
Background: Pulse wave velocity ratio (PWV-ratio), a measure of central-to-peripheral arterial stiffness gradient, is calculated as a quotient between carotid-femoral and carotid-radial PWV (cf-PWV/cr-PWV). This new index has been reported to be significantly associated with increased mortality in hemodialyzed patients. Since several reports showed differences in arterial stiffness regarding the pathway where the vascular access (VA) is, the purpose of this research was: a) to compare arterial stiffness values obtained in the left and right sides of the body in hemodialyzed and non-hemodialyzed patients, and b) to analyze PWV-ratio values obtained on the side of the body where the VA was placed and compare them to its contralateral intact side. Since it is difficult to adequately measure cr-PWV in patients with a VA in the forearm, we measured the carotid- brachial PWV (cb-PWV) and used it to calculate PWV-ratio (cf-PWV/cb-PWV)., Methods: A Pearson's correlation and Bland & Altman analysis were performed in hemodialyzed (n=135) and non-hemodialyzed (n=77) patients, to quantify the equivalence between arterial stiffness parameters (cf-PWV, cb-PWV, PWV-ratio) obtained on each side of the body with respect to its contralateral side., Results: We conclude that PWV-ratio values measured on the side where the VA is placed were significantly higher than those obtained in its contralateral side, in hemodialyzed patients included in this research. Moreover, cf-PWV, cb-PWV and PWV-ratio values obtained on one side of the body were always highly correlated with its contralateral side., Conclusion: According to this research, any research involving PWV-ratio should always consider the observed territory., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.)
- Published
- 2018
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11. Aortic-Radial Pulse Wave Velocity Ratio in End-stage Renal Disease Patients: Association with Age, Body Tissue Hydration Status, Renal Failure Etiology and Five Years of Hemodialysis.
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Bia D, Valtuille R, Galli C, Wray S, Armentano R, Zócalo Y, and Cabrera-Fischer E
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- Age Factors, Aged, Blood Pressure, Body Composition, Case-Control Studies, Cross-Sectional Studies, Diabetic Nephropathies diagnosis, Diabetic Nephropathies etiology, Diabetic Nephropathies physiopathology, Electric Impedance, Female, Humans, Kidney Failure, Chronic diagnosis, Kidney Failure, Chronic etiology, Kidney Failure, Chronic physiopathology, Male, Middle Aged, Predictive Value of Tests, Risk Factors, Time Factors, Treatment Outcome, Water-Electrolyte Balance, Aorta physiopathology, Diabetic Nephropathies therapy, Kidney Failure, Chronic therapy, Pulse Wave Analysis, Radial Artery physiopathology, Renal Dialysis adverse effects, Vascular Stiffness
- Abstract
Introduction: The etiology of the end-stage renal disease (ESRD) and the hydration status may be involved in the arterial stiffening process observed in hemodialyzed patients. The ratio between carotid-femoral and carotid-radial pulse wave velocity (PWV ratio) was recently proposed to characterize the patient-specific stiffening process., Aims: to analyze: (1) the PWV-ratio in healthy and hemodialyzed subjects, analyzing potential changes associated to etiologies of the ESRD, (2) the PWV-ratio and hydration status using multiple-frequency bioimpedance and, (3) the effects of hemodialysis on PWV-ratio in a 5-year follow-up., Methods: PWV-ratio was evaluated in 151 patients differentiated by the pathology determining their ESRD. Total body fluid (TBF), intra and extra cellular fluid (ICF, ECF) were measured in 65 of these patients using bioelectrical-impedance. The association between arterial, hemodynamic or fluid parameters was analyzed. PWV-ratio was evaluated in a group of patients (n = 25) 5 years later (follow-up study)., Results: PWV-ratio increased in the ESRD cohort with respect to the control group (1.03 ± 0.23 vs. 1.31 ± 0.37; p < 0.001). PWV-ratio in the diabetic nephropathy group was higher than in all other etiological groups (1.61 ± 0.33; p < 0.05). PWV-ratio was associated with TBF (r = -0.238; p < 0.05), ICF (r = -0.323; p < 0.01), ECF/ICF (r = 0.400; p < 0.001) and ECF/TBF (r = 0.403; p < 0.001). PWV-ratio calculated in ESRD patients in 2007 increased 5 years later (1.14 ± 0.32 vs. 1.43 ± 0.44; p < 0.005)., Conclusions: PWV-ratio increased the most in patients with diabetic nephropathy. PWV ratio was significantly associated with age and body hydration status, but not with the blood pressure. PWV-ratio could be considered a blood pressure-independent parameter, associated with the age and hydration status of the patient.
- Published
- 2017
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12. Hemodialysis Decreases the Etiologically-Related Early Vascular Aging Observed in End-Stage Renal Disease: A 5-Year Follow-Up Study.
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Bia D, Galli C, Zócalo Y, Valtuille R, Wray S, Armentano R, and Cabrera-Fischer E
- Subjects
- Aging, Carotid Arteries physiopathology, Case-Control Studies, Femoral Artery physiopathology, Follow-Up Studies, Humans, Kidney Failure, Chronic complications, Pulse Wave Analysis methods, Kidney Failure, Chronic therapy, Renal Dialysis
- Abstract
Aims: To analyze the early vascular aging (EVA) in end-stage renal disease (ESRD) patients, attempting to determine a potential association between EVA and the etiology of ESRD, and to investigate the association of hemodialysis and EVA in ESRD patients during a 5-year follow-up period., Methods: Carotid-femoral pulse wave velocity (cfPWV) was obtained in 151 chronically hemodialyzed patients (CHP) and 283 control subjects, and in 25 CHP, who were followed-up after a 5-year lapse., Results: cfPWV increased in ESRD patients compared to control subjects. The cfPWV-age relationship was found to have a steeper increase in ESRD patients. The highest cfPWV and EVA values were observed in patients with diabetic nephropathy. Regression analysis demonstrated a significant reduction of the EVA in HD patients on a 5-year follow-up., Conclusion: Patients in ESRD showed higher levels of EVA. cfPWV and EVA differed in ESRD patients depending on their renal failure etiology. CHP showed an EVA reduction after a 5-year follow-up period., (© 2016 S. Karger AG, Basel.)
- Published
- 2017
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13. Hemodialysis decreases carotid-brachial and carotid-femoral pulse wave velocities: A 5-year follow-up study.
- Author
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Cabrera Fischer EI, Bia D, Galli C, Valtuille R, Zócalo Y, Wray S, and Armentano RL
- Subjects
- Carotid Arteries physiology, Female, Follow-Up Studies, Humans, Male, Middle Aged, Prognosis, Prospective Studies, Time Factors, Carotid Arteries abnormalities, Kidney Failure, Chronic complications, Pulse Wave Analysis methods, Renal Dialysis adverse effects
- Abstract
Aortic stiffness is a prognostic parameter associated with patient mortality. Vascular access creation has been shown to have effects on arterial stiffness both in the aorta and in the upper limb arteries in chronically hemodialyzed patients (CHPs). However, no longitudinal studies have been conducted in order to characterize the evolution of arterial stiffness in CHPs. The aims of this work were (a) to measure baseline pulse wave velocity (PWV) in the carotid-femoral and in right and left carotid-brachial pathways in a cohort of CHP and (b) to conduct a 5-year prospective study on the same cohort to determine possible time-related differences. Pulse wave velocity was measured both in the carotid-femoral and in the carotid-brachial pathways, and clinical and biochemical parameters were collected in 25 CHPs, which were followed up after a 5-year lapse. Right and left carotid-brachial pathway PWV values showed significant decreases after the 5-year follow-up, independently of the presence of the vascular access (P < 0.001). Additionally, baseline carotid-brachial PWV was significantly higher (P < 0.001) than values measured 5 years later for upper limbs with vascular access (11.97 ± 2.97 m/sec vs. 6.76 ± 1.48 m/sec, respectively) and without vascular access (12.25 ± 2.38 m/sec vs. 7.18 ± 1.88 m/sec, respectively). Similarly, PWV values in the carotid-femoral pathway decreased significantly (P < 0.001) over the same period (13.27 ± 2.96 m/sec vs. 9.75 ± 2.99 m/sec, respectively). The 5-year follow-up of PWV showed significant decreases in both carotid-brachial and carotid-femoral pathways. The general changes in arterial stiffness could be related to the vascular access creation, hemodialysis therapy, and to the improvement of arterial pressure management., (© 2015 International Society for Hemodialysis.)
- Published
- 2015
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14. Nutritional Markers and Body Composition in Hemodialysis Patients.
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Valtuille R, Casos ME, Fernandez EA, Guinsburg A, and Marelli C
- Abstract
The aims of this study were to analyse body composition, to detect the presence of undernutrition, and to establish a relationship between undernutrition and the biological markers routinely used as indicators of nutritional status in hemodialysis (HD) patients (pts). We used a body composition monitor (BCM) that expresses body weight in terms of lean tissue mass (LTM) and fat tissue mass (FTM) independent of hydration status. From nine HD units, 934 pts were included. Undernutrition was defined as having a lean tissue index (LTI = LTM/height(2)) below the 10th percentile of a reference population. Biochemical markers and parameters delivered by BCM were used to compare low LTI and normal LTI groups. Undernutrition prevalence was 58.8% of the population studied. Low LTI pts were older, were significantly more frequently overhydrated, and had been on HD for a longer period of time than the normal LTI group. FTI (FTI = FTM/ height(2)) was significantly higher in low LTI pts and increased according to BMI. LTI was not influenced by different BMI levels. Albumin and C-reactive protein correlated inversely (r = -0.28). However neither of them was statistically different when considering undernourished and normal LTI pts. Our BCM study was able to show a high prevalence of undernutrition, as expressed by low LTI. In our study, BMI and other common markers, such as albumin, failed to predict malnutrition as determined by BCM.
- Published
- 2015
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15. Hydration Status Is Associated with Aortic Stiffness, but Not with Peripheral Arterial Stiffness, in Chronically Hemodialysed Patients.
- Author
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Bia D, Galli C, Valtuille R, Zócalo Y, Wray SA, Armentano RL, and Cabrera Fischer EI
- Abstract
Background. Adequate fluid management could be essential to minimize high arterial stiffness observed in chronically hemodialyzed patients (CHP). Aim. To determine the association between body fluid status and central and peripheral arterial stiffness levels. Methods. Arterial stiffness was assessed in 65 CHP by measuring the pulse wave velocity (PWV) in a central arterial pathway (carotid-femoral) and in a peripheral pathway (carotid-brachial). A blood pressure-independent regional arterial stiffness index was calculated using PWV. Volume status was assessed by whole-body multiple-frequency bioimpedance. Patients were first observed as an entire group and then divided into three different fluid status-related groups: normal, overhydration, and dehydration groups. Results. Only carotid-femoral stiffness was positively associated (P < 0.05) with the hydration status evaluated through extracellular/intracellular fluid, extracellular/Total Body Fluid, and absolute and relative overhydration. Conclusion. Volume status and overload are associated with central, but not peripheral, arterial stiffness levels with independence of the blood pressure level, in CHP.
- Published
- 2015
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16. Vascular accesses for haemodialysis in the upper arm cause greater reduction in the carotid-brachial stiffness than those in the forearm: study of gender differences.
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Bia D, Cabrera-Fischer EI, Zócalo Y, Galli C, Graf S, Valtuille R, Pérez-Cámpos H, Saldías M, Alvarez I, and Armentano RL
- Abstract
Purpose. To evaluate in chronically haemodialysed patients (CHPs), if: (1) the vascular access (VA) position (upper arm or forearm) is associated with differential changes in upper limb arterial stiffness; (2) differences in arterial stiffness exist between genders associated with the VA; (3) the vascular substitute (VS) of choice, in biomechanical terms, depends on the previous VA location and CHP gender. Methods. 38 CHPs (18 males; VA in upper arm: 18) were studied. Left and right carotid-brachial pulse wave velocity (PWV(c-b)) was measured. In in vitro studies, PWV was obtained in ePTFE prostheses and in several arterial and venous homografts obtained from donors. The biomechanical mismatch (BM) between CHP native vessel (NV) and VS was calculated. Results/Conclusions. PWV(c-b) in upper limbs with VA was lower than in the intact contralateral limbs (P < 0.05), and differences were higher (P < 0.05) when the VA was performed in the upper arm. Differences between PWV(c-b) in upper limbs with VA (in the upper arm) with respect to intact upper limbs were higher (P < 0.05) in males. Independently of the region in which the VA was performed, the homograft that ensured the minimal BM was the brachial artery. The BM was highly dependent on gender and the location in the upper limb in which the VA was performed.
- Published
- 2012
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17. Vascular cryografts offer better biomechanical properties in chronically hemodialyzed patients: role of cryograft type, arterial pathway, and diabetic nephropathy as matching determinants.
- Author
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Zócalo Y, Bia D, Armentano RL, Galli C, Pérez H, Saldías M, Alvarez I, Valtuille R, and Cabrera-Fischer E
- Subjects
- Aged, Arteries transplantation, Biomechanical Phenomena, Cryopreservation, Diabetic Nephropathies therapy, Humans, Kidney Failure, Chronic therapy, Middle Aged, Polytetrafluoroethylene, Pulse, Renal Dialysis, Arteries physiology, Blood Vessel Prosthesis, Diabetic Nephropathies physiopathology, Elasticity, Kidney Failure, Chronic physiopathology, Transplants
- Abstract
This study aimed to characterize the following: (i) in chronically hemodialyzed subjects (CHDSs), with and without diabetic nephropathy (DN), and in healthy subjects (non-CHDSs) different arterial pathways stiffness to determine potential pathology-dependent, etiology- and/or pathway-dependent differences; and (ii) the biomechanical mismatch (BM) between arteries from non-CHDSs or CHDSs (with and without DN) and arterial cryografts, venous cryografts, and synthetic prosthesis to determine arterial pathway, pathology, and/or etiology-related differences in the substitute of election in terms of BM. Carotid-femoral and carotid-brachial pulse wave velocity (PWV) were measured in 30 non-CHDSs and 71 CHDSs (11 with DN). In addition, PWV was measured in arterial (elastic and muscular) and venous cryografts and in expanded polytetrafluorethylene prosthesis. The arterial pathways regional differences and the subjects' arterial pathways-substitutes BM were calculated. Arterial stiffness levels and regional differences were higher in CHDS than in non-CHDS. Among CHDS, those with DN showed higher stiffness in the aorto-femoral pathway and larger regional differences. Cryografts showed always the least BM. Non-CHDS and CHDS differed in the cryograft of election. In CHDS, the BM was related with the cryograft type, arterial pathway, and renal disease etiology. The BM could be minimized, selecting the most adequate cryograft type, taking into account the recipient specific characteristic (i.e., arterial pathway and renal disease etiology).
- Published
- 2010
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18. Vascular access localization determines regional changes in arterial stiffness.
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Cabrera Fischer EI, Bia D, Valtuille R, Graf S, Galli C, and Armentano RL
- Subjects
- Adult, Aged, Diabetes Complications physiopathology, Diabetes Complications therapy, Elasticity, Female, Humans, Kidney Failure, Chronic physiopathology, Male, Middle Aged, Regional Blood Flow, Arteriovenous Shunt, Surgical, Brachial Artery physiopathology, Carotid Arteries physiopathology, Femoral Artery physiopathology, Kidney Failure, Chronic therapy, Pulsatile Flow, Renal Dialysis, Upper Extremity blood supply
- Abstract
Background: Vascular access (VA) dysfunction is a common cause of hospitalization in chronically hemodialyzed patients (CHP) limiting the improvement in health and has been largely studied in order to decrease the morbidity events that involves both the artery and the vein used in the construction of the fistula. In parallel, patients in end-stage renal failure show an increase in arterial stiffness., Aim: The aims of this work were: (a) to evaluate arterial stiffness through pulse wave velocity (PWV) measurements in the carotid-brachial pathway where the arteriovenous fistulae (AVF) was constructed, and (b) to determine possible differences in arterial stiffness between the carotid-brachial pathway with and without VA., Methods: PWV, clinical and biochemical parameters were measured in 38 CHP. PWV was obtained in the carotid-femoral, and in the left and right carotid-brachial pathway., Results: Carotid-brachial PWV determination in upper limbs with AVF (10.07 +/- ;2.43 m/s) showed significantly lower values than those observed in the contra-lateral arm without VA (11.55 +/- ;2.27 m/s). Curiously, the PWV value observed in arms with an AVF was significantly lower in diabetic than in non-diabetic hemodialyzed patients (NDHP) (8.00 +/- ;2.86 m/s and 10.38 +/- ;2.33 m/s; respectively). Measurements of PWV in the carotid-femoral pathway in CHP showed a mean value of 14.09 +/- ;3.12 m/s. Carotid-femoral PWV in NDHP (14.06 +/- ;2.44 m/s) was significantly lower than that observed in the diabetic patients (16.87 +/- ;3.42 m/s)., Conclusions: Carotid-brachial PWV values obtained in the upper limbs, in which VAs were constructed, were significantly lower than that measured in intact arteries in the contra-lateral pathway in CHP.
- Published
- 2009
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19. Partial least squares regression: a valuable method for modeling molecular behavior in hemodialysis.
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Fernández EA, Valtuille R, Willshaw P, and Balzarini M
- Subjects
- Computer Simulation, Data Interpretation, Statistical, Humans, Least-Squares Analysis, Regression Analysis, Kidney blood supply, Kidney physiopathology, Models, Biological, Renal Circulation physiology, Renal Dialysis methods, Therapy, Computer-Assisted methods
- Abstract
The aim of this work was to use the Partial Least Squares Regression (PLS) technique to fit simple models for the interpretation of an underlying complex process. In this study, the technique was used to build a statistical model for molecular kinetic data obtained from hemodialyzed patients. By using PLS we derived statistical linear models for the prediction of the equilibrated urea concentration which would be reached 30-60 min after the end of the dialysis session. Models with an average relative prediction error (RPE) of less than 0.05% were achieved. The model predictive accuracy was evaluated in a cross-center study yielding an RPE < 3%. The chosen model was robust to variations such as sampling extraction time demonstrating a high capacity for modeling kinetics. It also was found to be useful for bedside monitoring. Finally, the PLS technique allowed identification of the most important co-variables in the model and of those patients with outlier patterns in their molecular dynamics.
- Published
- 2008
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20. Molecular kinetics modeling in hemodialysis: on-line molecular monitoring and spectral analysis.
- Author
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Fernández EA, Perazzo CA, Valtuille R, Willshaw P, and Balzarini M
- Subjects
- Adult, Aged, Algorithms, Female, Humans, Kinetics, Male, Metabolic Clearance Rate, Models, Biological, Monitoring, Physiologic methods, Urea analysis, Urea blood, Artifacts, Online Systems, Renal Dialysis methods
- Abstract
The knowledge of the underlying molecular kinetics is a key point for the development of a dialysis treatment as well as for patient monitoring. In this work, we propose a kinetic inference method that is general enough to be used on different molecular types measured in the spent dialysate. It estimates the number and significance of the compartments involved in the overall process of dialysis by means of a spectral deconvolution technique, characterizing therefore the kinetic behavior of the patient. The method was applied to 52 patients to reveal the underlying kinetics from dialysate time-concentration profiles of urea, which has a well-known molecular kinetic. Three types of behaviors were found: one-compartmental (exponential decay Tau = 180 +/- 61.64 minutes), bicompartmental (Tau1 = 24.96 +/- 19.33 minutes, Tau2 = 222.32 +/- 76.59 minutes), and tricompartmental (Tau1 = 23.03 +/- 14.21 minutes; Tau2 = 85.75 +/- 27.48 minutes; and Tau3 = 337 +/- 85.52 minutes). In patients with bicompartmental kinetics, the Tau2 was related to the level of dialysis dose. The study concluded that spectral deconvolution technique can be considered a powerful tool for molecular kinetics inference that could be integrated in on-line molecular analysis devices. Furthermore, the method could be used in the analysis of poorly understood molecules as well as in new hemodialysis target biomarkers.
- Published
- 2007
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- View/download PDF
21. Comparison of different methods for hemodialysis evaluation by means of ROC curves: from artificial intelligence to current methods.
- Author
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Fernández EA, Valtuille R, Presedo JM, and Willshaw P
- Subjects
- Female, Follow-Up Studies, Humans, Kidney Failure, Chronic therapy, Male, Middle Aged, Practice Guidelines as Topic, ROC Curve, Artificial Intelligence, Decision Support Techniques, Renal Dialysis methods
- Abstract
Background: The National Kidney Foundation Guidelines (DOQI) and the European Renal Association (ERA) have set standards for adequacy of hemodialysis treatment. They recommended minimum single pool doses of 1.2 (Kt/Vsp DOQI), and 1.4 (Kt/Vsp ERA) and a "standard" urea removal ratio (URR) of 65%. Here, we compare an Artificial Intelligence Method (AIM) based on an Artificial Neural Network (ANN) and the usual methods for hemodialysis treatment follow-up such as Smye, Daugirdas, standard urea reduction ratio (URR using post-dialysis urea concentration) and modified URR [Cheng et al. 2001] against equilibrated Kt/V and URR calculated using a 60 min post-dialysis urea concentration., Methods: We used ROC analysis to evaluate and compare these methodologies. We also propose a method to find a minimum target dose that maximizes the sensitivity, specificity and positive predictive values of the diagnostic tool., Results: From a URR point of view, the ANN, stdURR and mURR perform almost equally well with an area under the curve (AUC) of 0.90, 0.93 and 0.92, respectively, but the ANN achieved the lowest false positive rate (FPR = 7.94%) and error rate (ER = 12.7%). When Kt/V is used as a dose index, the logarithmic single-and double-pool equations perform almost equally (AUC 0.957 and 0.962), and the ANN method achieves an AUC of 0.934. The lowest FPR was for ANN and Kt/Vsp (4.76%), which also achieved the lowest ER of 6.39%., Conclusions: For both cases (URR and Kt/V), the minimum doses required to achieve the lowest FPR and ER for the standard methods (stdURR and Kt/Vsp) were higher than those reported by the DOQI guidelines, being 70% for stdURR and 1.35 for Kt/Vsp, whereas for those methods using the double-pool Kt/V or equilibrated URR, the dose targets were close to those recommended by DOQI and ERA. Our proposed method for target dose selection is easy to understand, and it takes into account both accuracy and confidence of the adequacy tool. We found the ANN method to be superior to the Smye method for estimation of equilibrated urea, and the results presented here suggest that ANN methods could be useful tools in the analysis of nephrology data.
- Published
- 2005
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22. Comparison of standard and artificial neural network estimators of hemodialysis adequacy.
- Author
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Fernández EA, Valtuille R, Rodriguez Presedo J, and Willshaw P
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Models, Biological, Predictive Value of Tests, Reference Values, Urea blood, Neural Networks, Computer, Renal Dialysis standards
- Abstract
The National Kidney Foundation and the European Renal Association recommend routine measurement of hemodialysis (HD) dose and have set standards for adequacy of treatment. We compare the results of five methods for HD dose estimation, classifying each result as adequate or inadequate on the basis of equilibrated (eq) Urea Reduction Ratio (URR(eq)) > or = 65% or Kt/V(eq) > or = 1.2, to assess the accuracy of each method as a diagnostic tool. Data from 113 patients from two different dialysis units were analyzed. Equilibrated postdialysis blood urea was measured 60 min after each hemodialysis session to calculate URR(eq) and Kt/V(eq), considered as gold standard indexes (GSI). URR and Kt/V were estimated by using the Smye formula, an artificial neural network (ANN), modified URR, the second generation Kt/V Daugirdas formula, and standard indexes based on postdialysis urea, then compared to the GSI. For URR, best estimator was ANN (error rate: ER% = 12.70), followed by modified URR (ER% = 17.46%), the Smye (ER% = 22.22), and standard URR (ER% = 23.81). For Kt/V, the Daugirdas equation and the ANN were similar (ER% = 9.52 and 11.11). The single-pool Kt/V (Kt/V(sp)) > or = 1.4 (ERA recommended) produced an ER% = 7.94 and a false positive rate (FPR%) equal to that shown by the ANN (FPR% = 3.17). According to the current threshold limits for HD dose adequacy, the ANN was a reliable and accurate tool for URR monitoring, better than the Smye and the modified URR methods. The use of the ANN urea estimation yields accurate results when used to calculate Kt/V. The Kt/V(sp) with an adequacy threshold of 1.4 is a superior approach for HD adequacy monitoring, suggesting that the current adequacy limits should be reviewed for both URR and Kt/V.
- Published
- 2005
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- View/download PDF
23. Influence of hemodialysis procedure on HCV RNA detection in serum and peripheral blood mononuclear cells.
- Author
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Fernández JL, Valtuille R, Butera H, Fay F, Lef L, and Rendo P
- Subjects
- Genotype, Hepatitis C complications, Humans, Kidney Failure, Chronic complications, Kidney Failure, Chronic therapy, Viral Load, Hepacivirus genetics, Hepatitis C diagnosis, Leukocytes, Mononuclear virology, RNA, Viral blood, Renal Dialysis
- Abstract
Aim: To assess whether hemodialysis procedure induces qualitative or quantitative changes in hepatitis C virus (HCV) RNA., Methods: We obtained blood samples in the 10 HCV RNA-positive patients of our hemodialysis unit before (sample I) and 5 min after a dialysis session (sample II), and before the next dialysis session (sample III). HCV RNA was tested by PCR in serum and peripheral blood mononuclear cells (PBMC). Serum viral load was measured by branched-DNA assay., Results: Serum HCV RNA was positive in samples I, II and III of the 10 patients. PBMC HCV RNA was detected in samples I, II and III of seven patients. Mean viral load was 1.43+/-0.99 Meq genome/mL in sample I, 0.86+/-0.40 Meq genome/mL in sample II and 1.27+/-0.56 Meq genome/mL in sample III., Conclusions: HCV load was low in most HCV RNA-positive patients. It had a downward trend during dialysis procedure but HCV RNA remained detectable in all serum samples and in most PBMC samples. Therefore, qualitative HCV RNA seems to be better than viral load to assess HCV infection in hemodialysis patients.
- Published
- 2004
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- View/download PDF
24. Dialysate-side urea kinetics. Neural network predicts dialysis dose during dialysis.
- Author
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Fernández EA, Valtuille R, Willshaw P, and Perazzo CA
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Monitoring, Physiologic methods, Treatment Outcome, Monitoring, Physiologic instrumentation, Neural Networks, Computer, Renal Dialysis standards, Urea analysis
- Abstract
Determination of the adequacy of dialysis is a routine but crucial procedure in patient evaluation. The total dialysis dose, expressed as Kt/V, has been widely recognised to be a major determinant of morbidity and mortality in haemodialysed patients. Many different factors influence the correct determination of Kt/V, such as urea sequestration in different body compartments, access and cardiopulmonary recirculation. These factors are responsible for urea rebound after the end of the haemodialysis session, causing poor Kt/V estimation. There are many techniques that try to overcome this problem. Some of them use analysis of blood-side urea samples, and, in recent years, on-line urea monitors have become available to calculate haemodialysis dose from dialysate-side urea kinetics. All these methods require waiting until the end of the session to calculate the Kt/V dose. In this work, a neural network (NN) method is presented for early prediction of the Kt/V dose. Two different portions of the dialysate urea concentration-time profile (provided by an on-line urea monitor) were analysed: the entire curve A and the first half B, using an NN to predict the Kt/V and compare this with that provided by the monitor. The NN was able to predict Kt/V is the middle of the 4h session (B data) without a significant increase in the percentage error (B data: 6.69% +/- 2.46%; A data: 5.58% +/- 8.77%, mean +/- SD) compared with the monitor Kt/V.
- Published
- 2003
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25. Decline of high hepatitis C virus prevalence in a hemodialysis unit with no isolation measures during a 6-year follow-up.
- Author
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Valtuille R, Moretto H, Lef L, Rendo P, and Fernández JL
- Subjects
- Adult, Aged, Aged, 80 and over, Argentina, Female, Hepacivirus genetics, Hepacivirus isolation & purification, Hepatitis C prevention & control, Hepatitis C virology, Humans, Male, Middle Aged, Patient Isolation, Polymerase Chain Reaction, Prevalence, RNA, Viral blood, Risk Factors, Hemodialysis Units, Hospital, Hepatitis C epidemiology, Universal Precautions
- Abstract
Aims: It has been recently suggested that isolation measures may be necessary to avoid hepatitis C virus (HCV) spread in hemodialysis units with a high HCV prevalence. To assess the variation in prevalence and long-term incidence of HCV infection, we studied our hemodialysis patients during a 6-year follow-up period., Material and Methods: We compared anti-HCV prevalence in 1994, 1996, 1998 and 2000 according to the anti-HCV status, and we analyzed the seroconversion of anti-HCV. Strict adherence to universal precautions has been fulfilled since 1993 and systematic anti-HCV testing in blood donors has been performed since 1994. No isolation measures were adopted., Results: In 1994,22 of 53 (41.5%) patients tested positive for anti-HCV; in 1996, 18 of 67 (26.9%); in 1998,9 of 75 (12.0%); and in 2000, 7 of 82 (8.5%) (p < 0.001). In 2000, 7 of 14 (50.0%) patients who had been attending the unit since 1994 and 0 of 68 (0%) who had entered after 1994 were anti-HCV-positive (p = 0.000). Eight of 1 71 (4.7%) patients who entered the unit and 24 of 142 (16.9%) who left it were anti-HCV-positive (p < 0.001). Two patients became anti-HCV-negative. Seroconversion of anti-HCV was observed in 3 patients. The yearly seroconversion rate was 0.5% during the period 1994-1996 (1 of 98 patients at risk), 0.5% during the period 1996-1998 (1 of 91 patients at risk), and 0.4% during the period 1998-2000 (1 of 120 patients at risk)., Conclusions: It was possible to reduce a high HCV prevalence in a hemodialysis unit when a low incidence was achieved without taking isolation measures. All anti-HCV-positive patients in 2000 had been undergoing hemodialysis since 1994.
- Published
- 2002
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26. The role of transfusion-transmitted virus in patients undergoing hemodialysis.
- Author
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Valtuille R, Frankel F, Gómez F, Moretto H, Fay F, Rendo P, Lef L, and Fernández J
- Subjects
- Analysis of Variance, Argentina epidemiology, Chi-Square Distribution, Female, Genotype, Hepacivirus genetics, Humans, Male, Middle Aged, Polymerase Chain Reaction, Polymorphism, Restriction Fragment Length, Prevalence, RNA, Viral analysis, Risk Factors, Viremia, Blood-Borne Pathogens, DNA Virus Infections epidemiology, Renal Dialysis, Torque teno virus genetics, Transfusion Reaction
- Abstract
Goals: To study transfusion-transmitted virus (TTV) infection in 75 patients on hemodialysis and examine its relationship with age, sex, duration of dialysis, history of transfusion, and chronic elevation of alanine aminotransferase (ALT) levels., Study: Serum TTV was analyzed by polymerase chain reaction (PCR), TTV genotypes by restriction fragment length polymorphism, and hepatitis C virus (HCV) RNA by PCR., Results: Transfusion-transmitted virus was detected in 32 patients (42.7%). Transfusion-transmitted virus genotypes were as follows: G1 in 16 patients; G2, 3; G3, 1; G4, 2; G2-G5, 6; and unclassified, 4. Mean duration of dialysis was 37 +/- 32 months for TTV-positive patients and 43 +/- 37 months for TTV-negative patients (not significant). Twenty-seven (84%) TTV-positive patients and 27 (63%) TTV-negative patients had a history of transfusions ( p = 0.04). Chronic ALT elevation was observed in 9 patients; 5 of them were TTV-positive (16%) and 4 were TTV-negative (9%) (not significant). Four (40%) HCV RNA-positive patients and 5 (8%) HCV RNA-negative patients had chronic ALT elevation ( p = 0.003). Three TTV-positive patients with chronic ALT elevation were also infected with HCV. The two patients with isolated TTV infection did not have another clinical feature to explain their ALT elevation., Conclusions: Transfusion-transmitted virus had a high prevalence in the patients on hemodialysis; genotype G1 accounts for half of the cases. Transfusion-transmitted virus infection depends on the transfusional antecedent but not on the duration of dialysis. Chronic ALT elevation is significantly associated with HCV infection but not TTV infection. However, TTV could be a causative agent of chronic ALT elevation in some patients.
- Published
- 2002
- Full Text
- View/download PDF
27. Using artificial intelligence to predict the equilibrated postdialysis blood urea concentration.
- Author
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Fernández EA, Valtuille R, Willshaw P, and Perazzo CA
- Subjects
- Adult, Aged, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Artificial Intelligence, Renal Dialysis, Urea blood
- Abstract
Total dialysis dose (Kt/V) is considered to be a major determinant of morbidity and mortality in hemodialyzed patients. The continuous growth of the blood urea concentration over the 30- to 60-min period following dialysis, a phenomenon known as urea rebound, is a critical factor in determining the true dose of hemodialysis. The misestimation of the equilibrated (true) postdialysis blood urea or equilibrated Kt/V results in an inadequate hemodialysis prescription, with predictably poor clinical outcomes for the patients. The estimation of the equilibrated postdialysis blood urea (eqU) is therefore crucial in order to estimate the equilibrated (true) Kt/V. In this work we propose a supervised neural network to predict the eqU at 60 min after the end of hemodialysis. The use of this model is new in this field and is shown to be better than the currently accepted methods (Smye for eqU and Daugirdas for eqKt/V). With this approach we achieve a mean difference error of 0.22 +/- 7.71 mg/ml (mean % error: 1.88 +/- 13.46) on the eqU prediction and a mean difference error for eqKt/V of -0.01 +/- 0.15 (mean % error: -0.95 +/- 14.73). The equilibrated Kt/V estimated with the eqU calculated using the Smye formula is not appropriate because it showed a great dispersion. The Daugirdas double-pool Kt/V estimation formula appeared to be accurate and in agreement with the results of the HEMO study., (Copyright 2001 S. Karger AG, Basel.)
- Published
- 2001
- Full Text
- View/download PDF
28. Hepatitis G virus infection in hemodialysis patients and its relationship with hepatitis C virus infection.
- Author
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Fernandez JL, Valtuille R, Hidalgo A, del Pino N, Lef L, and Rendo P
- Subjects
- Aged, Alanine Transaminase blood, Argentina epidemiology, Female, Hepacivirus genetics, Hepatitis C blood, Hepatitis, Viral, Human blood, Hepatitis, Viral, Human transmission, Hepatitis, Viral, Human virology, Humans, Infant, Newborn, Male, Middle Aged, Prevalence, RNA, Viral analysis, Transfusion Reaction, Flaviviridae genetics, Hepatitis C epidemiology, Hepatitis, Viral, Human epidemiology, Renal Dialysis
- Abstract
Our aim was to study the characteristics of hepatitis G virus (HGV) infection in hemodialysis (HD) patients. We evaluated 108 patients from two different units (A: 67 patients; B: 41 patients). HGV RNA and HCV RNA were detected by PCR. Nineteen patients (17.6%) were HGV RNA positive (20.9% in unit A and 12.2% in unit B (NS)). HCV RNA was positive in 19 patients (17.6%) (28.4% in unit A and 0 in unit B (p < 0.01)). Eight patients were HGV RNA and HCV RNA positive (group I), 11 HGV RNA positive (group II), 11 HCV RNA positive (group III), and 78 negative for both viruses (group IV). Time on HD was 51.3 +/- 37.0 months for group I, 36.0 +/- 27.9 months for group II, 63.5 +/- 40.2 months for group III, and 26.4 +/- 27.1 months for group IV (p < 0.01 for I and III). Seven patients (87.5%) from group I, 9 (81.8%) from group II, 10 (90.9%) from group III, and 44 (56.4%) from group IV had a history of transfusion (p < 0.03 for I, II and III). Two patients (25%) from group I, none from group II, 5 (45.4%) from group III, and 6 (7.7%) from group IV had chronic ALAT elevation (p < 0.01 for I and III). We conclude that HGV infection was frequent in our HD patients, related to transfusions and independent of HCV prevalence, and that HGV infection itself was not a cause of ALAT elevation suggesting chronic hepatitis., (Copyright 2000 S. Karger AG, Basel)
- Published
- 2000
- Full Text
- View/download PDF
29. Evidence of hepatitis C virus passage across dialysis membrane.
- Author
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Valtuille R, Fernández JL, Berridi J, Moretto H, del Pino N, Rendo P, and Lef L
- Subjects
- Adult, Artifacts, Female, Humans, Male, Middle Aged, Polymerase Chain Reaction, Ultrafiltration, Viral Load, Hepacivirus isolation & purification, Hepatitis C transmission, Membranes, Artificial, Renal Dialysis instrumentation
- Abstract
The passage of hepatitis C virus (HCV) across the dialysis membrane is a controversial issue. We performed a study applying extreme conditions of permeability to the dialysis membrane and avoiding the use of heparin and dialysis bath that might interfere with polymerase chain reaction (PCR) results. We obtained samples from the ultrafiltrate at the beginning of 18 hemodialysis sessions carried out in 6 HCV RNA-positive patients. HCV RNA was detected by PCR in 3 (16.7%) ultrafiltrate samples belonging to 1 of the patients. HCV genotype was the same as that found in positive ultrafiltrate samples and in the serum corresponding to this patient. The viral load of this patient was under the levels detectable by the assay employed. Therefore, contamination of the ultrafiltrate may constitute a potential risk for HCV transmission in hemodialysis units.
- Published
- 1998
- Full Text
- View/download PDF
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